Multiplex blood PCR in combination with blood cultures for improvement of microbiological documentation of infection in febrile neutropenia.

Details

Serval ID
serval:BIB_A64C6B86455E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Multiplex blood PCR in combination with blood cultures for improvement of microbiological documentation of infection in febrile neutropenia.
Journal
Journal of Clinical Microbiology
Author(s)
Lamoth F., Jaton K., Prod'hom G., Senn L., Bille J., Calandra T., Marchetti O.
ISSN
1098-660X[electronic], 0095-1137[linking]
Publication state
Published
Issued date
2010
Volume
48
Number
10
Pages
3510-3516
Language
english
Abstract
The frequent lack of microbiological documentation of infection by blood cultures (BC) has a major impact on clinical management of febrile neutropenic patients, especially in cases of unexplained persistent fever. We assessed the diagnostic utility of the LightCycler SeptiFast test (SF), a multiplex blood PCR, in febrile neutropenia. Blood for BC and SF was drawn at the onset of fever and every 3 days of persistent fever. SF results were compared with those of BC, clinical documentation of infection, and standard clinical, radiological, and microbiological criteria for invasive fungal infections (IFI). A total of 141 febrile neutropenic episodes in 86 hematological patients were studied: 44 (31%) microbiologically and 49 (35%) clinically documented infections and 48 (34%) unexplained fevers. At the onset of fever, BC detected 44 microorganisms in 35/141 (25%) episodes. Together, BC and SF identified 78 microorganisms in 61/141 (43%) episodes (P = 0.002 versus BC or SF alone): 12 were detected by BC and SF, 32 by BC only, and 34 by SF only. In 19/52 (37%) episodes of persistent fever, SF detected 28 new microorganisms (7 Gram-positive bacterial species, 15 Gram-negative bacterial species, and 6 fungal species [89% with a clinically documented site of infection]) whereas BC detected only 4 pathogens (8%) (P = 0.001). While BC did not detect fungi, SF identified 5 Candida spp. and 1 Aspergillus sp. in 5/7 probable or possible cases of IFI. Using SeptiFast PCR combined with blood cultures improves microbiological documentation in febrile neutropenia, especially when fever persists and invasive fungal infection is suspected. Technical adjustments may enhance the efficiency of this new molecular tool in this specific setting.
Keywords
polymerase-chain-reaction, real-time pcr, piperacillin-tazobactam monotherapy, coagulase-negative staphylococci, molecular diagnosis, stream infections, invasive aspergillosis, fungal pathogens, rapid detection, sepsis
Pubmed
Web of science
Open Access
Yes
Create date
27/10/2010 15:24
Last modification date
20/08/2019 16:11
Usage data